OBJECTIVES : To assess the cost-effectiveness of induction and maintenance treatment up to 1 year of UC with infliximab (IFX), adalimumab (ADA), golimumab (GLM) and vedolizumab (VDZ) compared to standard of care in Poland.

METHODS : A Markov model was used to estimate the expected costs and effects of 4 biologics and placebo in patients with a diagnosis of moderately to severely active UC who had an inadequate response, lost response, or were intolerant to a conventional therapy. Prior exposure to anti-TNF was considered. At the beginning of the maintenance phase, the decision to continue biological therapy was determined by the achievement of response or remission at the end of induction. Efficacy data were obtained from a network meta-analysis using placebo as the common comparator. Costs were presented in 2019 Polish zloty (PLN) and outcomes included quality-adjusted life-years (QALYs). The analysis was performed from the Polish public payer’s perspective and lifetime horizon was set.

RESULTS : In anti-TNF-naive patients incremental cost-effectiveness ratios for IFX, ADA, GLM and VDZ compared to placebo were as follows: 145,287; 470,122; 328,498 and 208,822 PLN/QALY. In anti-TNF-exposed patients incremental cost-effectiveness ratios for ADA and VDZ compared to placebo were as follows: 380,542 and 195,096 PLN/QALY, respectively.

CONCLUSIONS : Although obtained results for all biological therapies are placed above the acceptability threshold in Poland, for anti-TNF-naive UC patients infliximab and for anti-TNF-exposed UC patients vedolizumab are the most cost-effective alternatives.